Surgery Commons^™

National Early Warning Score (News): Medical Surgical Unit Pilot, Electronic Hospital-Wide Roll-Out, And Unit Educational Case Studies, Leslie Farrington, Rn, Bsn, Ccrn, Mackenzie Brown, Rn, Bsn, Molly Cody, Rn, Bsn, Megan Greco, Rn, Bsn, Cecille Lamorena Bsn, Rn, Ccrn-K, Crystal Martinez, Rn, Bsn, Jacoba Walsh, Rn, Bsn, Elizabeth Winokur, Phd, Rn, Cen

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Smoke Evacuation In The Operating Room, Kristina Macalalag Salacup, Rn, Bsn, Cnor

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Limb Salvage Therapy In Septic Diabetic Foot Ulcer In Patients Unwilling To Undergo Amputation, Luke Hong

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Shojaiefard A, Khorgami Z, Larijani B. Septic diabetic foot is not necessarily an indication for amputation. J Foot Ankle Surg. 2008;47(5):419-423. https://doi.org/10.1053/j.jfas.2008.05.005

for a patient with a septic diabetic foot.

Klebsiella Pneumoniae Cryptogenic Liver Abscess And Endophthalmitis – A Case Report And Review Of Literature, Mihai Leonard Grecescu, Monica Grecescu, Andreea Smarandache Maria, Cristian Mihai Branescu, Anca Anghelache, Anca Silvia Dumitriu, Stana Paunica, Andreea Cristina Costea

Journal of Mind and Medical Sciences

Klebsiella pneumoniae has emerged as the predominant pathogenic agent of liver abscess in Asia, and the incidence is increasing worldwide. Hypervirulent strains are associated with septic metastatic dissemination in the eyes, lungs, and central nervous system, causing severe morbidity. We present the case of a 54year old man, with no previous comorbidities, admitted in emergency for the blind red painful eye. Further investigation documented septic endophthalmitis with transscleral extension and orbital cellulitis. Thoraco-abdominal computed tomography evidenced a hepatic abscess as the locus of the primary infection. Intravenous antibiotherapy with cefuroxime, followed by meropenem and vancomycin were efficient for managing the …

A Rare Complication In A Covid-19 Positive Patient With Sigmoid Colon Cancer-Hemoperitoneum Due To Gallbladder Necrosis Following Micro-Thrombosis, Mihai Faur, Andrei Moisin, Calin Mohor, Dan Sabau

Journal of Mind and Medical Sciences

Covid-19, also known as acute respiratory syndrome 2019-nCoV, severe acute respiratory syndrome (SARS) 2, and Wuhan pneumonia, is a viral respiratory disease caused by a SARS-associated coronavirus (SARS-CoV-2). The most serious complications of Covid-19 are due to the development of micro-thrombosis in various organs and systems as a result of the high levels of pro-inflammatory cytokines (tumor necrosis factor alpha, interleukin 1 and 6) which initiate the activation of coagulation and the generation of thrombin. Several studies demonstrated the poor outcome of Covid-19-infected patients who underwent surgery, suggesting that surgery may accelerate and exacerbate Covid-19 progression. We report the case …

The Management Of Tubo-Ovarian Abscesses Associated With Appendicitis, Lucian Serbanescu, Diana Badiu, Stere Popescu, Dimitrie Busu, Andreea Cristina Costea

Journal of Mind and Medical Sciences

A relatively uncommon medical complication, the tubo-ovarian abscess (TOA) can result from ascending pelvic infection in the female genital tract. The paper aims at exploring the characteristics of patients with TOA and at comparing the outcomes of the surgical management with postoperative recovery. A retrospective analysis of 25 cases diagnosed with bilateral, right or left TOA at “St. Apostol Andrei” Emergency Clinical County Hospital Constanta, Romania between January 2019 and December 2020 was performed. The patients’ clinical characteristics, age, environment of origin, socio-economic background, educational level, the means of contraception used, surgical procedures, and postoperative recovery were analyzed. Out of …

Esophageal Atresia Associating Gastrointestinal Malformations: A Study Of Clinical Approach, Dan Alexandru Iozsa, Andreea Cristina Costea, Nicolae Sebastian Ionescu

Journal of Mind and Medical Sciences

Digestive tract malformations requiring surgical repair in association with esophageal atresia are rare occurrences. Because of this uncommon presentation of esophageal atresia, its evaluation and management are often difficult, requiring extensive workup and multiple surgical procedures. We present our experience with esophageal atresia associating gastrointestinal congenital anomalies in the last 10 years. Clinical and surgical perspectives were pointed willing to make relevant observations in matters of diagnosis and treatment strategy in these patients. Therefore, 7 cases resembling this pattern were identified – duodenal atresia and anorectal malformation being the most common coexistent malformations. All the cases exhibited technical and procedural …

The Impact Of Patient-Dependent Risk Factors On Morbidity And Mortality Following Gastric Surgery For Malignancies, Bogdan Dumitriu, Sebastian Valcea, Gabriel Andrei, Mircea Beuran

Journal of Mind and Medical Sciences

Gastric cancer remains a leading cause of mortality worldwide. The treatment for gastric cancer is multimodal, in which gastrectomy remains the only curative approach. However, gastric resection is often associated with increased morbidity and mortality rates, depending on several factors. These factors can be attributed to the patient as comorbidities or effects of the disease upon him and, on the other hand, there are risk factors independent of the patient, such as aspects of the tumor (type, staging, location), experience of the surgical and anesthetic team, logistics of the hospital, yield of adjuvant therapies etc. We recognize the fact that …

Intestinal Dysbiosis – A New Treatment Target In The Prevention Of Colorectal Cancer, Florinela-Andrada Dumitru, Sergiu Ioan Micu, Roxana Emanuela Popoiag, Marilena Musat, Andreea Daniela Caloian, Valentin Calu, Vlad Denis Constantin, Daniela Gabriela Balan, Cornelia Nitipir, Florin Enache

Journal of Mind and Medical Sciences

The gastrointestinal microbiome contains at least 100 trillion microorganisms (bacteria, viruses, fungi), whose distribution varies from the mouth to the rectum spatially and temporally throughout one's lifetime. The microbiome benefits from advancing research due to its major role in human health. Studies indicate that its functions are immunity, metabolic processes and mucosal barrier. The disturbances of these functions, dysbiosis, influence physiology, lead to diabetes, inflammatory bowel disease, obesity and colon tumorigenesis. The third most common form of cancer, colorectal cancer, is the result of many factors and genes, and although the link between dysbiosis and this type of cancer is …

How Opportune Is Multigene Testing In Metastatic Colorectal Cancer? A Review, Cristina Orlov-Slavu, Andreea Parosanu, Mihaela Olaru, Dragos Serban, Ioana Paunica, Cornelia Nitipir

Journal of Mind and Medical Sciences

Personalized treatment in oncology is the most innovative method of care. The best method to establish personalized treatment is by genetic characterization of the malignant cell.

Theoretically, the more detailed the characterization, the more effective the choice of treatment becomes. Currently, there are fast and relatively low-cost options that allow such genetic characterization. However, test results sometimes do not detect targetable alterations and, even if they do detect, the use of the treatment-alteration combination does not always generate a satisfactory oncological response.

The present paper aims to answer two questions. First, how targetable can the most common gene alterations in …

Hepatocellular Carcinoma With Extrahepatic Blood Supply From Right Renal Artery, Amir Humza Sohail, Ahmad Musa, Muhammad Salman Khan, Hassan Raza Hashmi, Basit Salam, Collin E M. Brathwaite

Department of Radiology

Extrahepatic blood supply is seen in around 17-27% of hepatocellular carcinoma lesions. Evidence suggests that this extrahepatic supply most commonly originates from a right intercostal artery (70-83%) followed by left intercostal, omental and right renal arteries. Thus a comprehensive knowledge of variations in standard vascular anatomy and cognisance of factors influencing or predicting extrahepatic blood supply in HCC is instrumental in ensuring the success of surgical and interventional procedures. We present the unusual case of a 66-year-old male with HCC in Segment I of the liver with aberrant blood supply from the right renal artery in the absence of any …

Output Consistency Scale To Standardize Ostomate Output Description In Clinical Practice And Studies, Lisa Whisenhunt, Linda Xu, Fan Yang, Jacques Izard

Food for Health: Publications

Stool descriptors have become popular due to the large diffusion of the Bristol Stool Form Scale (BSFS) via clinical studies, clinical trials, and social media. The applications have been numerous and centered around standardization of terminology that can be used by health care professionals and patients alike, as well as individuals interested in their wellness and the associated partners in the wellness industry. For a portion of the population, the digestive content is rerouted to an external manufactured pouch or bag, making the use of the BSFS visual descriptors of stool difficult. From day one post-resection surgery, ostomates are challenged …

Dynamic Network Connectivity Reveals Markers Of Response To Deep Brain Stimulation In Parkinson’S Disease, Chengyuan Wu, Caio Matias, Thomas Foltynie, Patricia Limousin, Ludvic Zrinzo, Harith Akram

Department of Neurosurgery Faculty Papers

Background: Neuronal loss in Parkinson’s Disease (PD) leads to widespread neural network dysfunction. While graph theory allows for analysis of whole brain networks, patterns of functional connectivity (FC) associated with motor response to deep brain stimulation of the subthalamic nucleus (STN-DBS) have yet to be explored.

Objective/Hypothesis: To investigate the distributed network properties associated with STN-DBS in patients with advanced PD.

Methods: Eighteen patients underwent 3-Tesla resting state functional MRI (rs-fMRI) prior to STN-DBS. Improvement in UPDRS-III scores following STN-DBS were assessed 1 year after implantation. Independent component analysis (ICA) was applied to extract spatially independent components (ICs) from the …

Dynamic Network Connectivity Reveals Markers Of Response To Deep Brain Stimulation In Parkinson's Disease, Chengyuan Wu, Caio Matias, Thomas Foltynie, Patricia Limousin, Ludvic Zrinzo, Harith Akram

Department of Neurosurgery Faculty Papers

Background: Neuronal loss in Parkinson's Disease (PD) leads to widespread neural network dysfunction. While graph theory allows for analysis of whole brain networks, patterns of functional connectivity (FC) associated with motor response to deep brain stimulation of the subthalamic nucleus (STN-DBS) have yet to be explored.

Objective/Hypothesis: To investigate the distributed network properties associated with STN-DBS in patients with advanced PD.

Methods: Eighteen patients underwent 3-Tesla resting state functional MRI (rs-fMRI) prior to STN-DBS. Improvement in UPDRS-III scores following STN-DBS were assessed 1 year after implantation. Independent component analysis (ICA) was applied to extract spatially independent components (ICs) from the …

Lobectomy For Acquired Lobar Emphysema Months Following Newborn Repair Of Congenital Diaphragmatic Hernia, Mary Froehlich, Lance Horner, Joseph Stathos, Craig Nakamura, Michael G. Scheidler

School of Medicine Faculty Publications

Chronic lung disease is a known morbidity of congenital diaphragmatic hernia repair. Although described as a diffuse lung process, we present a case of localized lobar emphysema in a child with a congenital diaphragmatic hernia repair successfully treated with lobectomy. We aim to describe this unique clinical manifestation, detail the intraoperative findings, and describe the successful postoperative course.

Prevalence Of Os Acromiale In An Indigenous East African Population: A Computerized Tomography Scan-Based Study, Mordicai Atinga, Njalalle Baraza, Sarah Wambui, Wachira Joseph Thiong’O, Angela Atinga

General Surgery, East Africa

Background: Failure of fusion to any of the acromion physes at maturity may lead to an os acromiale. A radiological review into the prevalence of os acromiale in an indigenous East African population was performed using computer tomography (CT) imaging. The study aimed to demonstrate a lower prevalence of os acromiale in an urban population compared with cadaveric studies.

Methods: This was a cross-sectional study with consecutive sampling. CT scans of both shoulders obtained for non-shoulder pathology were used for the analysis. CT scanning was performed at a tertiary referral hospital from January 2019 to July 2020.

Results …

Short-Term Impact Of Bracing In Multi-Level Posterior Lumbar Spinal Fusion, Ryan Dimentberg, Saurabh Sinha, Gregory Glauser, Ian F. Caplan, James M. Schuster, Scott Mcclintock, Jang W. Yoon, Paul J. Marcotte, Zarina S. Ali, Neil R. Malhotra

Mathematics Faculty Publications

Background: Clinical practice in postoperative bracing after posterior lumbar spine fusion (PLF) is inconsistent between providers. This paper attempts to assess the effect of bracing on short-term outcomes related to safety, quality of care, and direct costs.

Methods: Retrospective cohort analysis of consecutive patients undergoing multilevel PLF with or without bracing (2013-2017) was undertaken (n = 980). Patient demographics and comorbidities were analyzed. Outcomes assessed included length of stay (LOS), discharge disposition, quality-adjusted life years (QALY), surgical-site infection (SSI), total cost, readmission within 30 days, and emergency department (ED) evaluation within 30 days.

Results: Amongst the study population, 936 were …

Opioid Free Multimodal Analgesia Versus Opioid Based Analgesia In Bariatric Surgery Outcome, Zeinab Ibrahim, Gihan Eldosoky, Kamal Abosonna

Al-Azhar International Medical Journal

Background: Combined Opioid-free analgesia (OFA) and thoracic epidural (TE) by ultrasound is the technique that may have an enhanced recovery after surgery (ERAS), decrease perioperative opioid consumption and more improved positive outcomes than balanced general anesthesia with use of opioid after bariatric surgery. The Opioid free analgesia includes local anesthetics (Na channel blocker), alpha-2 receptor agonists (dexmetedomidine), NMDA antagonists (ketamine, lidocaine, magnesium sulfate), anti-inflammatory drugs (NSAID) and dexamethasone. Aim: evaluation the effect of opioid free analgesia with thoracic epidural as a multimodal analgesia versus balanced general analgesia on outcome of bariatric surgery on total opioid requirements, pain scores, and complications. …

Impact Of Maternal Body Mass Index On Progress And Outcome Of Labor In Nulliparous Females, Omar El-Sayed, Ismail El-Garhy, Ahmed Saeed

Al-Azhar International Medical Journal

Background; the body mass index (BMI) is frequently used to classify the severity of obesity and to inform weight-gain guidelines throughout pregnancy. Aim and objectives; to evaluate the impact of BMI of nulliparous females on progress of labour, incidence of peri-partum complications (1ry outcome) and neonatal outcome of these women (secondary outcome). Subjects and methods; This is a prospective cohort study, was carried out on 330nulliparous patients attending the labor ward of Al-Hussein and Sayed Galal hospitals, Al-Azhar University, Egypt, during active phase of labor, divided into 4 groups, from January 2021 until the end of the specified cases. Result; …

Assessment Of Serum Level Of Cxcl9 And Cxcl10 In Cutaneous Versus Systemic Lupus Erythematosus, Ghada Omar, Sabila Mosa, Radwa Morsy, Radwa Tirana, Nagla Abdelaty

Al-Azhar International Medical Journal

Abstract Introduction: Lupus erythematosus has been a chronic inflammatory illness where chemokines play a great role in its pathogenesis. CXCL9 and CXCL10 are chemokines that were researched in a variety of inflammatory skin disorders for their crucial role in immune responses. Aim of the Work: To compare CXCL9 and CXCL10 serum levels in patients suffering from cutaneous versus systemic lupus erythematosus. Patients and Methods: The forty-five Egyptian patients in this case-control research were collected from the University Hospital's outpatient clinic between October 2018 and June 2019. Two groups of patients were established: DLE Group (Fifteen patients), and SLE group (Thirty …